Discussion of public health and health care policy, from a public health perspective. The U.S. spends more on medical services than any other country, but we get less for it. Major reasons include lack of universal access, unequal treatment, and underinvestment in public health and social welfare. We will critically examine the economics, politics and sociology of health and illness in the U.S. and the world.

Tuesday, January 24, 2012

Common Sense

You may feel that all taxation is theft, and that the nanny state should not be trying to influence us to do what's good for us, and that the corporations who sell us flavored sugar water are people. Okay, fine. But let's inject some facts into the discussion and see where that leads us.

As these folks point out in Health Affairs, Americans consume on average 45 gallons of sugary beverages every year. (That's soda, sugar sweetened tea, fruit punch (with minimal fruit, of course) "sports" drinks -- which are nothing of the sort -- all of that. It's all the same. Sugar, water and flavoring.) A 20 ounce drink contains 17 teaspoons of sugar. Those 45 gallons add up to 70,000 empty calories per person. So what, you say? Women who consume just one of these per day have been found to have an 83-98% increased risk of diabetes. It's partly because it makes them fat, and it's partly because it causes a glycemic spike. Put another way: that shit is poison.

So, these people figured out, based on estimates of how price would affect demand, that putting a one penny per ounce tax on these drinks nationwide would result in a reduction in the obesity rate of 1.5%, which means 867,000 fewer obese adults. It would reduce the incidence of diabetes over 10 years by 2.6%. This is even assuming that people would make up 40% of the calories by eating or drinking other stuff. If they didn't do that, we'd save $20 billion in medical costs. That would also mean 95,000 fewer cases of heart disease, 8,000 fewer strokes, and more than $17 billion in medical expenses averted.

Now, there are all sorts of caveats and reservations and what ifs behind all this, but the basic conclusion is clear. The price of these beverages does not reflect their cost to society -- the "externalities" of the transaction. We haven't even mentioned the cost to individuals of poor health, disability, and premature death. But those medical expenses are mostly paid by Medicare, which means you are paying.

So under which situation do you have more freedom? The situation where you can still choose not to poison yourself and save the extra 20 cents on a drink, while not having to pay as much for other people's health care not to mention your own? Or the situation we have now, where corporations are aggressively marketing poison to children and nobody is doing anything about it, but you have to pay the cost?